[Endoscopic treatment of gastroesophageal reflux disease]

Gastroesophageal reflux disease (GERD) is highly prevalent in the general population, and the treatment is mostly medical. However, lifelong therapy with proton pump inhibitors is expensive, and some patients with GERD have surgery because of unsatisfying symptom control, poor compliance or lack of acceptance of lifelong medical therapy. In the last couple of years, four endoscopic treatment options for GERD have evolved. These are endoscopic suturing, gastroplication, local radiofrequency treatment and injection of biopolymer into the gastroesophageal junction. The results so far have been promising regarding symptomatic control and patient satisfaction. The lack of normalized pH in the lower esophagus, however, and the lack of a physiological background for the impressing symptomatic effect, plus the fact that there has been only one sham-controlled randomized clinical trial, suggest that carefulness should be exercised in utilizing the procedures until more solid evidence is available. The methods in themselves are promising, though, and will probably have a natural position in the future treatment of GERD.